Hypoxia
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缺氧( hypoxia) PowerPoint PPT Presentation


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缺氧( hypoxia). 第一节 概述 一.氧的摄取、输送和利用. 缺氧:供氧↓或用氧异常→代谢、功能、甚至形态结构都可能发生异常变化的病理过程。. 一.常用的血氧指标: 1.血氧分压 ( partial pressure of oxygen, PO 2 ): 定义:溶解于血液的氧所产生的张力. 正常值: PaO 2 :100mmHg (13.3kPa) PvO 2 :40mmHg (5.33kPa). 影响因素 :. PaO 2 : 吸入气氧分压和肺呼吸功能 PvO 2 : 可反映内呼吸状态.

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缺氧( hypoxia)

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hypoxia


.



.1.partial pressure of oxygen, PO2:


PaO2:100mmHg (13.3kPa) PvO2:40mmHg (5.33kPa)


PaO2:

PvO2:


2.(oxygen binding capacity, CO2max100mlHb:CO2max=1.34(ml/g)Hb(15g/dl) 20 ml/dl


Hb


3.oxygen content, CO2:100mlO2 Hb() (0.3ml/dl)


CaO2 19 ml/dlCvO2 14 ml/dl

PO2Hb


4.SO2HbCO2- CO2SO2= CO2max 100% = CO2max 100%


SaO2 98% SvO2 70%

PO2


(ODCSO2PO2S


2,3DPG [H+] PCO2

HbO2

HbO2


5. -CaO2-CvO21005ml/dl



O2PaO2CaO2O2(= CaO2)


(1)(

(2)(

(3)


PaO2 CO2max CaO2 SaO2 CaO2CvO2 N CaO2CvO2 : N()


(cyanosis)

>50g/L,


(

HbCO2maxCaO2O2(= CaO2)


(1)(2)CO HbCO + O2HbO2+ CO


a.CO + HbFe2+HbFe2+CO,;

b.COHbO2210,COHb;


c.CO2,3DPG,HbO2;


(3) HbFe2+HbFe3+OH


a.MHbFe3+OH

b.


( ) MHb


(4)Hb:a.2,3DPGb.pHc.Hb


PaO2 CO2max CaO2 SaO2 CaO2CvO2 N N


CO()or

MHbor


O2 () O2


(1)(2)


PaO2 CO2max CaO2 SaO2 CaO2CvO2 N N N N


O2O2


(1)(): (CN),


Cytaa3Fe3+ Cytaa3Fe2+

CN+ Cytaa3Fe3+Cytaa3Fe3+CN,


(2)/ (3) VitB1B2PP


PaO2 CO2max CaO2 SaO2 CaO2CvO2N N N N (HbO2)


: ;


CaO2


.()PaO2(<60mmHg)


*


.1. 2. 3. 4.


1.(1)()(2)(3)


2.

(1)

(2) ()


3. (1)(2)LTs,TXA2,ET(3)Ca2+Na+


?


4. VEGF


()

1.

(1):

(2) EPO


2. 2,3-DPG

(1)2,3-DPG,,

(2)2,3-DPGpHBohr


?

Hb



1.:,2.3.4.




.()

1.

Na+Ca2+K+

2.

3.


()CNS()


()1.2.3.4.


1.CNS; 2. /


:PiO2PaO2SaO2CaO2


  • CO;


>0.5


(1) (1 8)(2) 2~3


1..5. 2..( ).,2001,83.. .20028


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